Maternal and Perinatal Outcomes in Pregnant Women with Takayasu’s Arteritis: 10 Years Retrospective Study at Tertiary Centre in South India

Abstract

Takayasu’s arteritis (TA) is a rare medical disorder of probable immune aetiology which complicates pregnancy. It affects younger women predominantly and may have a significant impact on maternal and foetal health. To study the maternal and perinatal outcomes among pregnant women with TA, attending a dedicated obstetric hospital in South India. It is a retrospective observational study done at Fernandez Hospital, Hyderabad, with 10,000 births per annum. All women with TA-complicating pregnancies who were birthed from 2005 to 2022 were included. American College of Rheumatology criteria were used for the diagnosis of TA. The primary outcome of interest was to analyse the type of TA, maternal and foetal outcomes in pregnant women with TA. The secondary outcome of interest was to compare foetal outcomes between pregnancies managed at Fernandez Hospital (group A) versus previous pregnancies managed elsewhere (group B). During the study period, there were 119,053 births of which 38 women had TA, with a total of 92 pregnancies, of which 59 pregnancies were in group A and 33 pregnancies in group B. Type 4 was the commonest seen in 44% of women. Hypertensive disorders of pregnancy were seen in 67.7% of women. The live birth rate was 84%, miscarriages were 10% and 5% of women had stillbirths. Caesarean section rate was 59.3%. There was one maternal mortality. TA should be considered in young women with secondary hypertension. Maternal and foetal outcomes are good with appropriate diagnosis, treatment and management of complications.